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    Effects of preoperative plasma exchange therapy with albumin replacement fluid on blood coagulation in patients undergoing ABO-incompatible living-donor kidney transplantation using rotational thromboelastometry.
    BMC Anesthesiol 2018 Jun 19;18(1):68. Epub 2018 Jun 19.
    Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
    Background: ABO-incompatible living-donor kidney transplantation (LDKT) requires immunotherapy and plasma exchange therapy (PEX). PEX with albumin replacement fluid reportedly decreases fibrinogen levels. However, no reports have described the effects of PEX with albumin replacement fluid on blood coagulation parameters and blood loss during the perioperative period. Read More

    Effects of acute ethanol intoxication in an ovine peritonitis model.
    BMC Anesthesiol 2018 Jun 19;18(1):70. Epub 2018 Jun 19.
    Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
    Background: Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model.

    Methods: Anesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i. Read More

    Is intra-bladder pressure measurement a reliable indicator for raised intra-abdominal pressure? A prospective comparative study.
    BMC Anesthesiol 2018 Jun 19;18(1):69. Epub 2018 Jun 19.
    Department of Urology, Saqr Hospital, Ras Al Khaimah, United Arab Emirates.
    Background: Intra-abdominal pressure (IAP) can be measured by several indirect methods; however, the urinary bladder is largely preferred. The aim of this study was to compare intra-bladder pressure (IBP) at different levels of IAPs and assess its reliability as an indirect method for IAP measurement.

    Methods: We compared IBP with IAP in twenty-one patients undergoing laparoscopic cholecystectomy under general anesthesia. Read More

    And the Band Played On: The Unrelenting Search for Preventative Analgesia.
    Anesthesiology 2018 Jun 19. Epub 2018 Jun 19.
    From the Department of Anesthesiology and Critical Care Medicine, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland; Pain Treatment Center, Walter Reed National Military Medical Center, Bethesda, Maryland; and Department of Anesthesiology and Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

    Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.
    Anesthesiology 2018 Jun 15. Epub 2018 Jun 15.
    From the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California (K.K.M., J.M.L.) Department of Kinesiology, University of Indianapolis, Indianapolis, Indiana (A.M.B.-S.) Virginia Polytechnic Institute and State University, Center for Gerontology, Blacksburg, Virginia (L.P.S.).
    Background: Postoperative delirium complicates approximately 15 to 20% of major operations in patients at least 65 yr old and is associated with adverse outcomes and increased resource utilization. Furthermore, patients with postoperative delirium might also be at risk of developing long-term postoperative cognitive dysfunction. One potentially modifiable variable is use of intraoperative processed electroencephalogram to guide anesthesia. Read More

    Plasticity and Function of Spinal Oxytocin and Vasopressin Signaling during Recovery from Surgery with Nerve Injury.
    Anesthesiology 2018 Jun 15. Epub 2018 Jun 15.
    From the Departments of Anesthesiology (A.L.S., K.H., C.A.A., C.M.P., S.G., J.C.E.) Physiology and Pharmacology (R.C., H.S., J.C.E.) School of Medicine (B.P.), Wake Forest School of Medicine, Winston-Salem, North Carolina.
    Background: Recovery from pain after surgery is faster after cesarean delivery than after other abdominal procedures. The authors hypothesized that recovery in rats after surgery could be reversed by antagonism of spinal oxytocin or vasopressin receptors, that there may be a sex difference, and that spinal oxytocin innervation could change after surgery.

    Methods: Male and female rats underwent partial spinal nerve ligation surgery. Read More

    Paravertebral dexmedetomidine as an adjuvant to ropivacaine protects against independent lung injury during one-lung ventilation: a preliminary randomized clinical trial.
    BMC Anesthesiol 2018 Jun 15;18(1):67. Epub 2018 Jun 15.
    Department of Anesthesiology, Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou City, Henan Province, China.
    Background: To investigate the effect of paravertebral dexmedetomidine as an adjuvant to ropivacaine on independent lung injury during one-lung ventilation.

    Methods: In total, 120 patients who underwent elective radical resection of pulmonary carcinoma were randomly assigned to one of six groups (n = 20): normal saline (C group), ropivacaine (R group), intravenous dexmedetomidine (Div group), 0.5 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD0. Read More

    Bispectral index to guide induction of anesthesia: a randomized controlled study.
    BMC Anesthesiol 2018 Jun 15;18(1):66. Epub 2018 Jun 15.
    Department of Anesthesia and Intensive Care, University Hospital Giessen-Marburg, Marburg Campus, Baldingerstraße, 35033, Marburg, Germany.
    Background: It is unknown to what extent hypotension frequently observed following administration of propofol for induction of general anesthesia is caused by overdosing propofol. Unlike clinical signs, electroencephalon-based cerebral monitoring allows to detect and quantify an overdose of hypnotics. Therefore, we tested whether the use of an electroencephalon-based cerebral monitoring will cause less hypotension following induction with propofol. Read More

    Decannulation of tracheotomized patients after long-term mechanical ventilation - results of a prospective multicentric study in German neurological early rehabilitation hospitals.
    BMC Anesthesiol 2018 Jun 13;18(1):65. Epub 2018 Jun 13.
    University of Potsdam, Center of Rehabilitation Research, Am Neuen Palais 10, 14469, Potsdam, Germany.
    Background: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation.

    Methods: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65. Read More

    Does implementation of an enhanced recovery after surgery program for hip replacement improve quality of recovery in an Australian private hospital: a quality improvement study.
    BMC Anesthesiol 2018 Jun 13;18(1):64. Epub 2018 Jun 13.
    Epworth HealthCare, 89 Bridge Rd, Richmond, Vic, 3121, Australia.
    Background: Enhanced recovery after surgery programs may improve recovery and reduce duration of hospital stay after joint replacement surgery. However, uptake is incomplete, and the relative importance of program components is unknown. This before-and-after quality improvement study was designed to determine whether adding 'non-surgical' components, to pre-existing 'surgical' components, in an Australian private healthcare setting, would improve patient recovery after total hip replacement. Read More

    High-throughput Screening in Larval Zebrafish Identifies Novel Potent Sedative-hypnotics.
    Anesthesiology 2018 Jun 12. Epub 2018 Jun 12.
    From the Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (X.Y., B.Y.) Department of Anesthesia, Critical Care and Pain Medicine (X.Y., Y.J., J.B.D., F.M.-O., E.S.H., S.A.F.) Center for Regenerative Medicine (R.D.), Massachusetts General Hospital, Boston, Massachusetts Department of Chemistry and Center for Molecular Discovery, Boston University, Boston, Massachusetts (L.E.B., R.T., W.X., S.E.S., J.A.P.).
    Background: Many general anesthetics were discovered empirically, but primary screens to find new sedative-hypnotics in drug libraries have not used animals, limiting the types of drugs discovered. The authors hypothesized that a sedative-hypnotic screening approach using zebrafish larvae responses to sensory stimuli would perform comparably to standard assays, and efficiently identify new active compounds.

    Methods: The authors developed a binary outcome photomotor response assay for zebrafish larvae using a computerized system that tracked individual motions of up to 96 animals simultaneously. Read More

    Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis.
    Anesthesiology 2018 Jun 12. Epub 2018 Jun 12.
    From Edwards Lifesciences Critical Care, Irvine, California (F.H., Z.J., S.B., C.L., J.S.) Department of Anesthesiology and Perioperative Care, School of Medicine (C.L., J.R., M.C.) Department of Computer Sciences (C.L.), and Department of Biomedical Engineering (C.L., M.C.), University of California, Irving, California Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California (K.S., M.C.).
    Background: With appropriate algorithms, computers can learn to detect patterns and associations in large data sets. The authors' goal was to apply machine learning to arterial pressure waveforms and create an algorithm to predict hypotension. The algorithm detects early alteration in waveforms that can herald the weakening of cardiovascular compensatory mechanisms affecting preload, afterload, and contractility. Read More

    Defining an Intraoperative Hypotension Threshold in Association with Stroke in Cardiac Surgery.
    Anesthesiology 2018 Jun 8. Epub 2018 Jun 8.
    From the Division of Cardiac Anesthesiology (L.Y.S., A.M.C., M.B.) the Division of Cardiac Surgery (M.R.) University of Ottawa Heart Institute, Ottawa, Ontario, Canada; the School of Epidemiology and Public Health (L.Y.S.) University of Ottawa, Ottawa, Ontario, Canada; Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada (L.Y.S.) Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada (M.E.F.) the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada (M.E.F.) the Department of Critical Care and Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada (S.v.D.) the Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, New York (J.W.).
    Background: Stroke is a leading cause of morbidity, mortality, and disability in patients undergoing cardiac surgery. Identifying modifiable perioperative stroke risk factors may lead to improved patient outcomes. The association between the severity and duration of intraoperative hypotension and postoperative stroke in patients undergoing cardiac surgery was evaluated. Read More

    Dexmedetomidine Prevents Excessive γ-Aminobutyric Acid Type A Receptor Function after Anesthesia.
    Anesthesiology 2018 Jun 8. Epub 2018 Jun 8.
    From the Departments of Physiology (D.-S.W., K.K., G.L., F.M., J.W., I.L., Y.-F.X., N.K.C., A.F.-E., A.J.R., B.A.O.) Anesthesia (A.S., B.A.O.) Pharmacology and Toxicology (A.J.R.) Ophthalmology and Vision Science (J.M.S.) the Leslie Dan Faculty of Pharmacy (Y.-F.X., R.P.B.) University of Toronto, Toronto, Ontario, Canada; the Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (S.A., B.A.O.) the Center for Neuroscience and Connectomics, Korea Institute of Science and Technology, Seoul, Korea (J.W., C.J.L.) the Division of Vision Sciences, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada (D.C., J.M.S.).
    Background: Postoperative delirium is associated with poor long-term outcomes and increased mortality. General anesthetic drugs may contribute to delirium because they increase cell-surface expression and function of α5 subunit-containing γ-aminobutyric acid type A receptors, an effect that persists long after the drugs have been eliminated. Dexmedetomidine, an α2 adrenergic receptor agonist, prevents delirium in patients and reduces cognitive deficits in animals. Read More

    Do Hospitals Performing Frequent Neuraxial Anesthesia for Hip and Knee Replacements Have Better Outcomes?
    Anesthesiology 2018 Jun 7. Epub 2018 Jun 7.
    From the Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York (S.G.M., C.C., E.E.M.) Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria (S.G.M., C.C., E.E.M.) Institute for Healthcare Delivery Science, Departments of Population Health Science and Policy (J.P., N.Z., A.O., M.M.) Departments of Orthopedic Surgery (J.P.) Medicine (J.P.) Icahn School of Medicine at Mount Sinai, New York, New York; Department of Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (E.R.M.) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California (E.R.M).
    Background: Neuraxial anesthesia is increasingly recommended for hip/knee replacements as some studies show improved outcomes on the individual level. With hospital-level studies lacking, we assessed the relationship between hospital-level neuraxial anesthesia utilization and outcomes.

    Methods: National data on 808,237 total knee and 371,607 hip replacements were included (Premier Healthcare 2006 to 2014; 550 hospitals). Read More

    Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?
    Anesthesiology 2018 Jun 6. Epub 2018 Jun 6.
    From the Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, United Kingdom (N.A.) the Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (J.R.P.) and the Adult Critical Care Unit and Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom (J.R.P.).

    Evaluation of hemodynamic goal-directed therapy to reduce the incidence of bone cement implantation syndrome in patients undergoing cemented hip arthroplasty - a randomized parallel-arm trial.
    BMC Anesthesiol 2018 Jun 6;18(1):63. Epub 2018 Jun 6.
    Department of Anaesthesiology and Critical Care, Medical Center - University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
    Background: The bone cement implantation syndrome (BCIS) is a frequent and potentially disastrous intraoperative complication in patients undergoing cemented hip arthroplasty. Several risk factors have been identified, however randomized controlled trials to reduce the incidence of BCIS are still pending. We hypothesized that goal-directed hemodynamic therapy guided by esophageal Doppler monitoring (EDM) may reduce the incidence of BCIS in a randomized, controlled parallel-arm trial. Read More

    Comparative addition of dexmedetomidine and fentanyl to intrathecal bupivacaine in orthopedic procedure in lower limbs.
    BMC Anesthesiol 2018 Jun 6;18(1):62. Epub 2018 Jun 6.
    Rasoul-e-Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran.
    Background: Spinal block is a common procedure for lower limbs surgery. Fentanyl, a synthetic opioid and dexmedetomidine, a selective α2 agonist have been used as adjuvants in spinal anesthesia to prolong intraoperative and postoperative analgesia. The aim of current study is to compare the efficacy of dexmedetomidine and fentanyl added to intrathecal bupivacaine in orthopedic procedures in lower limbs. Read More

    Evaluation of small intestinal damage in a rat model of 6 Minutes cardiac arrest.
    BMC Anesthesiol 2018 Jun 5;18(1):61. Epub 2018 Jun 5.
    Experimental Medicine, University Hospital of Cologne, Robert-Koch-Str.10, Cologne, Germany.
    Background: Contribution of the small intestine to systemic inflammation after cardiac arrest (CA) is poorly understood. The objective was to evaluate whether an in vivo rat model of 6 min CA is suitable to initiate intestinal ischaemia-reperfusion-injury and to evaluate histomorphological changes and inflammatory processes in the small intestinal mucosa resp. in sera. Read More

    Entrapment of a laryngotracheal topical anesthesia kit during tracheobronchial foreign body removal: a case report.
    BMC Anesthesiol 2018 Jun 1;18(1):60. Epub 2018 Jun 1.
    Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.
    Background: In order to reduce the irritation of the airway during tracheobronchial foreign body (TFB) removal, tracheal surface anesthesia is usually performed using a laryngotracheal topical anesthesia (LTA) kit (LTA20, Highgreen Medical Technology Company, China), but difficulty in withdrawing the LTA kit is rarely reported. We present a case of a difficulty to withdraw the LTA kit due to its entrapment by the movement of a TFB.

    Case Presentation: A 1-year-old girl was undergoing TFB removal. Read More

    Association between the use of a stylet in endotracheal intubation and postoperative arytenoid dislocation: a case-control study.
    BMC Anesthesiol 2018 May 31;18(1):59. Epub 2018 May 31.
    Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
    Backgrounds: Arytenoid dislocation (AD) is a rare but severe complication after general anesthesia with endotracheal intubation. We conducted a case-control study at Peking Union Medical College Hospital to identify risk factors associated with AD, including the use of an intubation stylet.

    Methods: Patients who experienced AD were matched 1:3 with controls based on gender, age and type of surgery. Read More

    My Love Affair with the Venous System.
    Anesthesiology 2018 May 31. Epub 2018 May 31.
    From the Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, and Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
    Aortic cross-clamping (AoX) and unclamping are associated with severe hemodynamic disturbances in virtually all organs and systems. The main hemodynamic changes induced by AoX result from an increase in impedance to aortic flow, an increase in systemic vascular resistance and afterload, blood volume redistribution caused by collapse and constriction of venous vasculature distal to the aortic clamp, and a subsequent increase in preload. Preload may not increase if the aorta is clamped distal to the celiac artery; in that case, blood volume from distal venous vasculature may be redistributed to the splanchnic vasculature without associated increases in preload. Read More

    Correction to: Advances in anesthesia technology are improving patient care, but many challenges remain.
    BMC Anesthesiol 2018 May 30;18(1):58. Epub 2018 May 30.
    Departments of Anesthesia and Health Research Methods, Evidence, and Impact, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, 1280 Main Street West Hamilton, Hamilton, ON, L8S 4L8, Canada.
    Unfortunately, after publication of this article [1], it was noticed that the name of Ashraf A. Dahaba is incorrectly displayed as Ashraf Dahaba. The full, corrected author list can be seen here. Read More

    Anesthesia Care Team Composition and Surgical Outcomes.
    Anesthesiology 2018 May 24. Epub 2018 May 24.
    From the Department of Anesthesiology, Pain, and Perioperative Medicine (E.C.S.) the Center for Health Policy and the Center for Primary Care and Outcomes Research (J.M.) and the Department of Health Research and Policy (E.C.S., L.C.B.) Stanford University School of Medicine, Stanford University, Stanford, California; the Department of Analytics and Research Services, American Society of Anesthesiologists, Schaumburg, Illinois (T.R.M.) and the National Bureau of Economic Research, Cambridge, Massachusetts (L.C.B.).
    Background: In the United States, anesthesia care can be provided by an anesthesia care team consisting of nonphysician providers (nurse anesthetists and anesthesiologist assistants) working under the supervision of a physician anesthesiologist. Nurse anesthetists may practice nationwide, whereas anesthesiologist assistants are restricted to 16 states. To inform policies concerning the expanded use of anesthesiologist assistants, the authors examined whether the specific anesthesia care team composition (physician anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was associated with differences in perioperative outcomes. Read More

    Effectiveness of Lumbar Facet Joint Blocks and Predictive Value before Radiofrequency Denervation: The Facet Treatment Study (FACTS), a Randomized, Controlled Clinical Trial.
    Anesthesiology 2018 May 30. Epub 2018 May 30.
    From the Department of Anesthesiology and Critical Care Medicine (S.P.C., T.L.D., M.A.-W.) and the Department of Neurology and Physical Medicine and Rehabilitation (S.P.C.) The Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Anesthesiology (S.P.C., S.R.G.) Department of Physical Medicine and Rehabilitation (S.P.C., M.B.J., W.J.K., P.F.P.) Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (O.C.C.) Department of Neurology, District of Columbia Veterans Affairs Hospital, Washington, District of Columbia (Z.Z.) Physical Medicine and Rehabilitation Service, Department of Orthopedic Surgery (P.F.P.) and Pain Treatment Center, Anesthesia Service, Department of Surgery (A.J.V., C.K., D.E.J., S.R.G.) Walter Reed National Military Medical Center, Bethesda, Maryland; Parkway Neuroscience and Spine Institute, Hagerstown, Maryland (T.M.L., S.E.S.) Puget Sound Veteran's Hospital, Seattle, Washington (T.C.D.) epartment of Pain Medicine, David Grant U.S. Air Force Medical Center, Travis Air Force Base, California (R.L.W.) Pain Medicine Center, Department of Anesthesiology, Naval Medical Center-San Diego, San Diego, California (I.M.F.) and Department of Anesthesiology, University of Washington, Seattle, Washington (T.C.D.).
    Background: With facet interventions under scrutiny, the authors' objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes.

    Methods: A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months. Read More

    Anaesthesia for chest wall reconstruction in a patient with Poland syndrome: CARE-compliant case report and literature review.
    BMC Anesthesiol 2018 May 24;18(1):57. Epub 2018 May 24.
    Department of Anesthesiology and Pain medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, People's Republic of China.
    Background: Poland syndrome is a rare congenital disease, characterized by agenesis/hypoplasia of the pectoralis major muscle, usually associated with variable thoracic anomalies that needed chest wall reconstruction under general anesthesia. Anaesthetic management in Poland syndrome has scarcely been described.

    Case Presentation: Here, we present our anaesthetic management of Nuss procedure for chest wall correction in a 5 years old patient with Poland syndrome. Read More

    In vitro investigation of the effects of exogenous sugammadex on coagulation in orthopedic surgical patients.
    BMC Anesthesiol 2018 May 24;18(1):56. Epub 2018 May 24.
    Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
    Background: Previous studies have shown that sugammadex resulted in the prolongation of prothrombin time and activated partial thromboplastin time. In this study, we aimed to investigate the in vitro effects of exogenous sugammadex on the coagulation variables of whole blood in healthy patients who underwent orthopedic surgery.

    Methods: The effects of sugammadex on coagulations were assessed using thromboelastography (TEG) in kaolin-activated citrated blood samples taken from 14 healthy patients who underwent orthopedic surgery. Read More

    Prediction of fluid responsiveness in mechanically ventilated cardiac surgical patients: the performance of seven different functional hemodynamic parameters.
    BMC Anesthesiol 2018 May 22;18(1):55. Epub 2018 May 22.
    Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital Zurich, Birmensdorferstr. 497, 8063, Zurich, Switzerland.
    Background: Functional hemodynamic parameters such as stroke volume and pulse pressure variation (SVV and PPV) have been shown to be reliable predictors of fluid responsiveness in mechanically ventilated patients. Today, different minimally- and non-invasive hemodynamic monitoring systems measure functional hemodynamic parameters. Although some of these parameters are described by the same name, they differ in their measurement technique and thus may provide different results. Read More

    Association between troponin-I levels and outcome in critically ill patients admitted to non-cardiac intensive care unit with high prevalence of cardiovascular risk factors.
    BMC Anesthesiol 2018 May 22;18(1):54. Epub 2018 May 22.
    Intensive Care Department, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
    Background: The association of troponin-I levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-I levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit.

    Methods: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011. Read More

    Liposomal Bupivacaine Does Not Reduce Inpatient Opioid Prescription or Related Complications after Knee Arthroplasty: A Database Analysis.
    Anesthesiology 2018 May 21. Epub 2018 May 21.
    From the Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York (L.P., C.C., S.G.M.) Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria (L.P., C.C., S.G.M.) Icahn School of Medicine at Mount Sinai, New York, New York (J.P., N.Z., M.M.) and Stanford University, Stanford, California (E.C.S.).
    Background: Although some trials suggest benefits of liposomal bupivacaine, data on real-world use and effectiveness is lacking. This study analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among patients undergoing total knee arthroplasties with a peripheral nerve block. It was hypothesized that liposomal bupivacaine has limited clinical influence on the studied outcomes. Read More

    Comparison of Tracheal Intubation Conditions in Operating Room and Intensive Care Unit: A Prospective, Observational Study.
    Anesthesiology 2018 May 22. Epub 2018 May 22.
    From the Department of Anesthesiology and Intensive Care Medicine, Clinical University Hospital of Santiago, Spain.
    Background: Tracheal intubation is a common intervention in the operating room and in the intensive care unit. The authors hypothesized that tracheal intubation using direct laryngoscopy would be associated with worse intubation conditions and more complications in the intensive care unit compared with the operating room.

    Methods: The authors prospectively evaluated during 33 months patients who were tracheally intubated with direct laryngoscopy in the operating room, and subsequently in the intensive care unit (within a 1-month time frame). Read More

    Respiratory Muscle Effort during Expiration in Successful and Failed Weaning from Mechanical Ventilation.
    Anesthesiology 2018 May 16. Epub 2018 May 16.
    From the Departments of Critical Care Medicine (J.D., L.H.R., J.G.v.d.H., L.M.A.H.) Anesthesiology (D.J.) and Pulmonary Diseases (H.W.H.v.H.) and the Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (J.D.) Radboud University Medical Center, Nijmegen, The Netherlands; and the Department of Intensive Care Medicine, VU University Medical Center, Amsterdam, The Netherlands (L.M.A.H.).
    Background: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. Read More

    Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery.
    Anesthesiology 2018 May 16. Epub 2018 May 16.
    From the Department of Anesthesiology and Critical Care Medicine (C.H.B., R.H., M.P.) Department of Surgery (Y.N., K.Z., K.M.) and Department of Psychiatry and Behavioral Sciences (V.K., K.J.N.) Johns Hopkins University School of Medicine, Baltimore, Maryland; New York University School of Medicine, New York, New York (J.P.) Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan (A.Y.) Biostatistics Consulting Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.T.) Department of Anesthesiology and Critical Care Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois (C.W.H.).
    Background: Delirium is common after cardiac surgery and has been associated with morbidity, mortality, and cognitive decline. However, there are conflicting reports on the magnitude, trajectory, and domains of cognitive change that might be affected. The authors hypothesized that patients with delirium would experience greater cognitive decline at 1 month and 1 yr after cardiac surgery compared to those without delirium. Read More

    Combined Recirculatory-compartmental Population Pharmacokinetic Modeling of Arterial and Venous Plasma S(+) and R(-) Ketamine Concentrations.
    Anesthesiology 2018 May 16. Epub 2018 May 16.
    From the Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado (T.K.H.) the Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado (T.K.H.) the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (M.J.A., T.C.K.) the Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands (A.D., E.O.) and the Department of Laboratory Medicine, Division of Clinical Pharmacology (L.L.G.) and the Department of Clinical Science, Intervention and Technology, Division of Anesthesiology (J.P.), Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden.
    Background: The pharmacokinetics of infused drugs have been modeled without regard for recirculatory or mixing kinetics. We used a unique ketamine dataset with simultaneous arterial and venous blood sampling, during and after separate S(+) and R(-) ketamine infusions, to develop a simplified recirculatory model of arterial and venous plasma drug concentrations.

    Methods: S(+) or R(-) ketamine was infused over 30 min on two occasions to 10 healthy male volunteers. Read More

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